Rheum

Question 1

Developing small red papule or pustules at site of sterile needle insertion 1-2 days later

Answer 1

Positive pathergy test. Typically indicative of Behcets

Question 2

Recurrent episodes of fever, abdominal pain, testicular pain and swelling of knees and ankles. Episodes last up to 72-96 hours

Answer 2

Familial Mediterranean Fever

Question 3

Recurrent episodes fever, aphthous ulcers, lymphadenopathy and malaise every 21 days

Answer 3

Cyclic Neutropenia

Question 4

Recurrent episodes fever, headache, N/V, oral/vaginal ulcers in those of Dutch or French descent

Answer 4

Hyper IgD syndrome

Question 5

Recurrent episodes fever, small joint arthralgias, periorbital edema and conjunctivitis. Episodes lasting 5days - 2 weeks

Answer 5

TNF receptor 1 associated periodic syndrome (TRAPS)

Question 6

Psoriatic Juvenile Arthritis Criteria

Answer 6

Arthritis and psoriasis OR arthritis PLUS two of the following three: dactylitis, nail findings (pitting, oil spots or oncholysis), a 1st degree relative with psoriasis

Question 7

Recurrent fevers, urticaria and joint pain. Later in life can develop sensorineural hearing loss and renal disease from amyloid deposits

Answer 7

Muckle-Wells syndrome - one of the cyropyrin-associated periodic syndromes. Cryopyrin is involved with IL-1 activation

Question 8

Back pain and stiffness with confluent ossification on imaging - usually on the right side of the spine

Answer 8

Diffuse Idiopathic Skeletal Hyperostosis

Question 9

Colchicine toxicity

Answer 9

Can occur with coadministration of clarithromycin or fluconazole. Presents with rhabdo, AKI and pancytopenia

Question 10

What should you consider when first initiation urate lowering therapy in gout?

Answer 10

These patients are at increased risk of flares in their initial period on urate lowering therapy due to mobilization attacks when urate body stores shift from joints to vasculature. They should have an NSAID or colchicine for first 6-12 months on urlate lowering therapy

Question 11

Infant with annular scaling/pinkish plaques and congenital heart block

Answer 11

Neonatal lupus

Question 12

Dactylitis with new periosteal bone formation on xray imaging of joint

Answer 12

Juvenile idiopathic arthritis

Question 13

Neonatal Lupus progression expectations

Answer 13

occurs due to placental passage of Anti Ro and anti La antibodies. Complete congential heat block is permanent - but the rest of signs and symptoms are transient and resolve over 4-6 months

Question 14

What mucocutaneous manifestiations occur with reactive arthritis?

Answer 14

Oral shalllow erosions and small pustules on the buccal mucosa, genital ulcers, balanitis and papular skin lesions

Question 15

Symmetric proximal muscle weakness, heliotrope dermatitie, erythematous papulosquamous eruption ovr dorsal knuckles (Gottron papules), elevation of muscle enzmes, necrosis/inflammation on muscle biopsy

Answer 15

Juvenile dermatomyositis

Question 16

Allodynia, hyperalgesia with autonomic dysfunction to the area of pain (edema, coolness/warmth, mottling/sweatiness)

Answer 16

Complex regional pain syndrome

Question 17

Behcet’s diagnostic criteria

Answer 17

outbreak of oral ulcerations at least 3 times a year AND at least 2 of the following (recurrent genital ulcers, uveitis or retinal vasculitis, skin lesions or positive pathergy test)

Question 18

Irregularity, flattening of cortical margines and distortion of femoral head

Answer 18

Avascular necrosis

Question 19

Bacteria associated with reactive arthritis

Answer 19

Shigella, S. typhi, Salmonella, viridans strep, mycoplasma, chlamydia and yersinia

Question 20

Periodic fevers for 3-7 days every 1-2 months with abdominal pain, diarrhea, nondestructive large joint arthritis, macular rash. Present typically by 1 year of age

Answer 20

HyperIGD syndrome